Eating disorders: Germany’s Next Pukemodel

21. May 2012
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The German Society for Psychosomatic Medicine and Medical Psychotherapy (DGPM) warns teenagers in particular against TV consumption of casting shows such as "Germany's Next Top Model".  As a new study shows, these have an influence in particular on the subjective body image of teenaged females who regularly follow such shows.

It often happens that many girls and young women, in response to viewing such shows, see themselves as too fat. Thus casting shows can increase the tendency toward eating disorders like anorexia or bulimia, warns DGPM. The society points out, for example, that anorexia without proper treatment rapidly becomes chronic, and can severely erode both the mental and physical aspects of health.

“Help I’m too fat”

Casting shows are especially with children and young people extremely popular, as a market share of up to more than 62 percent of those between 12 and 17years of age indicates. In the new study by the International Central Institute for Youth and Educational Television (IZI) [part of RadioTelevision Bavaria], 120 adolescents (98 girls and 22 boys) who follow Germany’s Next Top Model on a regular basis (GNTM) were openly surveyed in writing. Already in summer 2009, in a representative survey conducted by “iconkids & youth” 1166 representatively-selected children and adolescents aged from 9 to 19 years were interviewed face-to-face. The main motive given therein for following GNTM – “to see beautiful people” – met with 79 percent approval rating. The sentiments of the young audience fluctuated between envy and admiration. In general GNTM causes the viewer to eat less and/or exercise more. “Everyone wants to have model dimensions, because for girls our age things like appearance and body figure often are what it’s all about”, says one 13-year-old girl. “All candidates have such a great figure, that gives me incentive to slim down,” stated one 14-year-old. One 15-year-old girl said: “Then I often think to myself why I’m not so thin”. One eleven year old even pointed to her stomach and her legs as being too fat, because supermodels have to really be slim.

Although about 80 percent of girls are of normal weight, more than half of them are not satisfied with their bodies. The desire to “be leaner” and the dream of “a flat abdomen” often comes up, as does that of making changes to the face and legs (see iconkids & youth, 2009). “If, in spite of having normal weight girls feel themselves to be too fat, they are more prone to eating disorders such as anorexia nervosa (AN) or bulimia (bulimia nervosa, BN)” warns Professor Dr. Stephan Herpertz of the DGPM. Studies indicate that in Germany alone 0.8 percent of female teenagers between 14 and 20 years suffer anorexia and three percent suffer bulimia. What is meant by AN is self-induced malnutrition with weight loss up to the point of cachexia. Those affected thereby significantly limit their nutritional intake and reduce their weight actively, for example, by vomiting, excessive sport or by taking laxatives. Young women suffering from BN seek, by having what is often a high calorie diet, to impose on themselves constant fasting. At the same time nevertheless they lose personal control of their eating behaviour, which causes a vicious circle of overeating, vomiting and fasting.

Since 1994 binge-eating disorder (BES) has been left in the fourth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM IV) of the American Psychiatric Association, in the International Classification of Diseases (ICD-10) it can be found via key under the “unspecified eating disorders” category. The exact course of BES is still little explored, in the context of outpatient psychotherapy remission rates vary between 50-80 percent.

Up to 12 percent die from their eating disorders

Both AN and BN may bring severe psychological as well as physical damage with them. Such is the negative effect of anorexia on bone density in adolescents, linear growth and maturation of the brain are also affected negatively. In the worst case, eating disorders in up to 12 percent of these patients lead to death. “Eating disorders like anorexia have serious consequences for society”, therefore warns Prof. Herpertz of the Clinic for Psychosomatic Medicine and Psychotherapy of the University Hospital of Bochum. “They affect almost exclusively young people and hinder both their health and professional development”. For the treatment of patients the DGPM in a current scientific S3 guideline gives advice with a focus on psychotherapy, wherein cognitive behavioral therapy that is specifically geared to the particular eating disorder possesses the largest body of evidence. As an accompanying measure, the medication of selective serotonin-reuptake inhibitors (SSRIs) can also be recommended for bulimia nervosa. An evidence-based indication for pharmacotherapy of anorexia nervosa does not exist. While bulimia nervosa of mild and moderate severity and with a low mental comorbidity can be handled well with outpatient treatment, cases displaying the full picture of anorexia nervosa characteristics usually require hospitalisation.”Psychotherapy should renormalise eating behavior and resolve the psychological problems associated with the disease.

Curing anorexia occurs only with about half of the patients” says a spokesman for the guideline. In any case, a chronification of anorexia or bulimia must be avoided. The most important indicator with anorexia is the steady decline in body weight: while for adults a drop in body mass index (BMI) of 17.5 kg / m² is considered to be critical, in children and adolescents falling below the tenth percentile for age for BMI carries imminent danger. If one takes into account the three parameters weight, height and gender, this would mean that more than 90 percent of their peers weigh more than the victim. The distorted perception of one’s body as too fat despite being objectively underweight is another important warning sign for both anorexia as well as bulimia. “Casting shows such as GNTM certainly carry a hazard for young women which is not one to be underestimated and a public discourse might be important,” concludes Professor Herpertz . Where distorted ideals of beauty in extreme form can take somebody has most recently been demonstrated by the example of “Living Barbie”, Valeria Lukyanova. The Ukrainian woman has invested according to “Huffington Post” almost 600,000 € in her appearance. She wanted to resemble her idol, the Barbie Doll, as exactly as possible.

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